What role does obstetrical care play in childbirth?

A pregnant woman’s health care provider can be a source of information on all aspects of labor, delivery, and postpartum care. Some specific concerns that may arise include the following1:

Knowing when labor begins. This includes understanding and interpreting signs that a woman is approaching labor. One of these signs is when a woman’s "water breaks," which refers to the release of a watery substance that occurs when the fluid-filled sac surrounding the fetus ruptures. In contrast to popular belief, contractions are not always a sign that a woman will go into labor soon; they can sometimes occur weeks before a woman goes into labor. Because contractions are not always a sign of labor, a woman’s health care provider needs to determine whether she is experiencing labor contractions.

Recommending when labor should be induced. Labor may need to be induced (or started artificially) for a variety of reasons:

When complications develop or result from the presence of other high-risk factors, such as hypertension, preeclampsia, heart disease, gestational diabetes, or abnormal bleeding

If the fetus is in danger of not getting enough nutrients and oxygen

If the amniotic sac has ruptured (the woman’s water breaks), but labor does not start within 24 to 48 hours

When a pregnancy goes beyond 42 weeks

Providing pain relief. There are two types of pain-relieving drugs given during labor, analgesics and anesthetics. Analgesics offer relief of pain without total loss of feeling or muscle movement. An anesthetic can block all feeling, including pain. Recent studies suggest that 60% or more of pregnant women in the United States receive an epidural (pronounced ep-i-DOOR-uhl) or spinal anesthesia involving the injection of a pain reliever next to or into the lower region of the spine to provide regional pain relief.2 Epidural or spinal anesthesia is often administered by an anesthesiologist (pronounced an-uhs-thee-zee-OL-uh-jist).

Deciding if a cesarean delivery is needed. Cesarean delivery (also known as a c-section) is the delivery of a fetus through a surgical incision made through the abdominal wall and the uterine wall. A variety of factors may influence if a woman can have a vaginal birth or must have a cesarean instead.

Postpartum care. A new mother experiences many physical and emotional changes. Postpartum care encompasses the care for a new mother immediately after childbirth and for the following 6 weeks. In the hospital, obstetrical services would manage any complications that occur, such as infection, hemorrhage, high blood pressure, blood clot formation, opening of incisions, or breast problems. The woman could be referred for help with postpartum depression or other problems.

Obstetrical care often is provided by an OB/GYN or a trained health care provider. Some pregnant women seek out the services of a certified nurse-midwife or a certified midwife for care and support during pregnancy, labor, delivery, and the postpartum period3:

In addition, it is quite common for the father-to-be or a close friend or family member to serve as a labor coach to help and encourage the pregnant woman during labor and delivery. In some cases, a woman may choose to hire a trained and certified birth doula (pronounced DOO-luh) to serve as a knowledgeable and experienced labor coach while helping to keep her comfortable during labor and delivery.4